Part 1.
TEXAS DEPARTMENT OF HUMAN SERVICES
Chapter 20.
COST DETERMINATION PROCESS
40 TAC §20.112
The Texas Department of Human Services (DHS) proposes new §20.112,
concerning Attendant Compensation Rate Enhancement, in its cost determination
process chapter.
The purpose of the new section is to implement DHS's appropriations rider
37 regarding community care programs passed by the 76th legislature. The proposal
establishes procedures for providers to obtain additional funds for increased
compensation to attendants in select community care programs (Community Based
Alternatives Waiver, Community Living Assistance and Support Services, Primary
Home Care, Day Activity and Health Services, Deaf-Blind Multiple Disabilities
Waiver, and Residential Care). Providers receiving the additional funds must
demonstrate compliance with spending the increased funds on attendant compensation.
If a participating provider's allowable attendant compensation times 1.07
is less than the revenue accrued, the difference will be recouped by DHS.
Providers who choose not to participate will have their total direct care
staff rate increase each year limited to adjustments necessitated by increases
in the minimum wage. The proposal modifies the cost areas of these programs
to separate the new attendant compensation cost area from other cost areas.
Changes to the Day Activity and Health Services, Primary Home Care, and Residential
Care programs are proposed to combine some of the cost areas.
The department is simultaneously proposing related policy in Chapters 46,
47, and 98, along with the Texas Health and Human Services Commission's Chapter
355, in this issue of the
Texas Register
.
Eric M. Bost, commissioner, has determined that for the first five-year
period the proposed section will be in effect there will be fiscal implications
for state government as a result of enforcing or administering the section.
The effect on state government for the first five-year period the sections
will be in effect is an estimated additional cost of $10,400,000 in fiscal
year (FY) 2001; $10,900,000 in FY 2002; $11,500,000 in FY 2003; $12,000,000
in FY 2004; and $12,600,000 in FY 2005. There will be no fiscal implications
for local government as a result of enforcing or administering the section.
Mr. Bost also has determined that for each year of the first five years
the section is in effect the public benefit anticipated as a result of enforcing
the section will be a mechanism for increasing compensation to attendants
in certain community care programs. There will be no adverse economic effect
on large, small, or micro businesses as a result of enforcing or administering
the section, because no changes in practice are required of any businesses.
The proposal will provide some additional funding for providers who choose
to increase the compensation paid to attendants in their programs. There is
no anticipated economic cost to persons who are required to comply with the
proposed section.
The department will hold a public hearing on the proposal on Monday, April
17, 2000, at 1:30 in the John H. Winters Building Public Hearing Room, first
floor, East Tower, 701 West 51st Street, Austin.
For further information, contact local offices of DHS or Carolyn Pratt
at (512) 438-4057 in DHS's Rate Analysis Division. Written comments on the
proposal may be submitted to Supervisor, Rules and Handbooks Unit-179, Texas
Department of Human Services E-205, P.O. Box 149030, Austin, Texas 78714-
9030, within 30 days of publication in the
Texas
Register
.
The new section is proposed under the Human Resources Code, Title
2, Chapters 22 and 32, which authorizes the department to administer public
and medical assistance programs; and under Texas Government Code §531.021,
which provides the Health and Human Services Commission with the authority
to administer federal medical assistance funds.
The new section implements the Human Resources Code, §§22.001
- 22.030 and §§32.001 - 32.042.
§20.112. Attendant Compensation Rate Enhancement.
(a)
Eligible programs. Providers contracted in the Primary
Home Care, including Family Care (PHC/FC); Day Activity and Health Services
(DAHS); Residential Care (RC); Community Living Assistance and Support Services
(CLASS) - Direct Service Agency; Community Based Alternatives (CBA) - Home
and Community Support Services (HCSS); Deaf-Blind Multiple Disabilities Waiver;
and CBA - Assisted Living/Residential Care (AL/RC) programs are eligible to
participate in the attendant compensation rate enhancement.
(b)
Definition of attendant. An attendant is the unlicensed
caregiver providing direct assistance to the clients with Activities of Daily
Living (ADL) and Instrumental Activities of Daily Living (IADL). In the case
of DAHS, RC, and AL/RC programs, the attendant must perform attendant functions
at least 80% of his or her total time worked. Other staff in these settings
not providing attendant services at least 80% of their total time worked are
not considered attendants. Time studies should be performed for staff that
are not full- time attendants to determine if a staff member meets this 80%
criteria. Attendants do not include the director, administrator, assistant
director, assistant administrator, clerical and secretarial staff, professional
staff, other administrative staff, licensed staff, attendant supervisors,
cooks and kitchen staff, maintenance and ground keeping staff, and laundry
and housekeeping staff. An attendant also includes a driver in the DAHS program.
(c)
Attendant compensation cost center. This cost center will
include employee compensation, contract labor costs, and personal vehicle
mileage reimbursement for attendants as defined in subsection (b) of this
section.
(1)
Attendant compensation is the allowable compensation for
attendants defined in §20.103(b)(1) of this title (relating to Compensation
of Employees) and required to be reported as either salaries and/or wages,
including payroll taxes and workers' compensation, or employee benefits. Benefits
required by §20.103(b)(1)(A)(iii) of this title (relating to Specifications
for Allowable and Unallowable Costs) to be reported as costs applicable to
specific cost report line items, except as noted in paragraph (3) of this
subsection, are not to be included in this cost center.
(2)
Contract labor refers to personnel for whom the contracted
provider is not responsible for the payment of payroll taxes, such as FICA,
Medicare, and federal and state unemployment insurance, and who perform tasks
routinely performed by employees where allowed by program rules. Allowable
contract labor costs are defined in §20.103(b)(2)(C) of this title (relating
to Specifications for Allowable and Unallowable Costs).
(3)
Mileage reimbursement paid to the attendant for the
use of his or her personal vehicle and which are not subject to payroll taxes
are considered compensation for this cost center.
(d)
Rate year. The rate year begins on the first day of September
and ends on the last day of August of the following year.
(e)
Open enrollment. Open enrollment begins on the first day
of July and ends on the last day of that same July preceding the rate year
for which payments are being determined.
(f)
Enrollment contract amendment. All contracted providers
must submit an enrollment contract amendment during the open enrollment period.
On the enrollment contract amendment the provider must specify for each contract
his desire to participate or his desire not to participate. The participating
provider must specify for each program if he wishes to have all participating
contracts be considered as a group or individually for purposes related to
the attendant compensation rate enhancement. The provider also must submit
with the contract amendment all required documentation to the Texas Department
of Human Services (DHS) in a manner specified by DHS. DHS will place on vendor
hold providers failing to submit an acceptable enrollment contract amendment
by the end of the open enrollment period until DHS receives and processes
an acceptable enrollment contract amendment.
(g)
New contracts. For the purposes of this section, for each
rate year a new contract is defined as a contract delivering its first day
of service to a DHS client on or after the first day of the open enrollment
period, as defined in subsection (e) of this section, for that rate year.
Contracts that underwent a contract assignment are not considered new contracts.
New contractors who must complete the enrollment contract amendment specified
in subsection (f) of this section within 30 days of notification by DHS. DHS
will place on vendor hold contracted providers failing to submit an acceptable
enrollment contract amendment within 30 days of notification until DHS receives
and processes an acceptable enrollment contract amendment. Based on the enrollment
contract amendment information received, the contracted provider's attendant
compensation rate will be adjusted effective on the sixty-first day of the
contract with DHS. New facilities will receive the attendant compensation
rate as specified in subsection (l) of this section for the first 60 days
of their contract with DHS.
(h)
Attendant Compensation Report submittal requirements.
Attendant Compensation Reports must be submitted by participating contracted
providers as follows.
(1)
Annual report. Participating contracted providers will
provide DHS, in a method specified by DHS, an annual Attendant Compensation
Report reflecting the activities of the provider while delivering contracted
services from the first day of the rate year through the last day of the rate
year. This report must be submitted for each participating contract if the
provider requested participation individually for each contract, or if the
provider requested participation as a group the report must be submitted as
a single aggregate report covering all participating contracts within one
program of the provider. The aggregate report must include terminated, excluded
from participation, new and contract assignment contracts, as defined in subparagraphs
(A)-(E) of this paragraph, which were part of the group for any portion of
the rate year. This report will be used as the basis for determining compliance
with the spending requirements and recoupment amounts as described in subsection
(s) of this section. Contracted providers failing to submit an acceptable
annual Attendant Compensation Report within 30 days of the end of the rate
year will be placed on vendor hold until such time as an acceptable report
is received and processed by DHS. Contracted providers participating for less
than a full year must provide attendant compensation reports as follows.
(A)
A participating provider whose contract is terminated
either voluntarily or involuntarily before the end of the rate year must submit
an Attendant Compensation Report within 30 days after the date recognized
by DHS as the contract termination date, covering the period from the beginning
of the rate year to the date recognized by DHS as the contract termination
date. This report will be used as the basis for determining recoupment as
described in subsection (s) of this section.
(B)
In cases where a participating provider changes ownership
through a contract assignment from one legal entity to another legal entity,
the owner prior to the change of ownership must submit an Attendant Compensation
Report within 30 days from the date of the contract assignment as determined
by DHS, covering the period from the beginning of the rate year to the effective
date of the contract assignment as determined by DHS. The owner after the
change of ownership must submit an Attendant Compensation report within 30
days of the end of the rate year, covering the period from the effective date
of the contract assignment as determined by DHS to the end of the rate year.
This report will be used as the basis for determining recoupment as described
in subsection (s) of this section.
(C)
A participating provider who is excluded from participation
as per subsection (u) of this section must submit an Attendant Compensation
Report within 30 days from the date of notification of the exclusion, covering
the period from the beginning of the rate year to the date of exclusion as
determined by DHS. DHS will use this report as the basis for determining recoupment
as described in subsection (s) of this section.
(D)
A participating provider who voluntarily withdraws from
participation as per subsection (x) of this section must submit an Attendant
Compensation Report within 30 days from the date of withdrawal as determined
by DHS, covering the period from the beginning of the rate year through the
date of withdrawal as determined by DHS. DHS will use this report as the basis
for determining recoupment as described in subsection (s) of this section.
(E)
A participating provider who is a new contract as per
subsection (g) of this section must submit an Attendant Compensation Report
within 30 days of the end of the rate year, covering the period from the sixty-first
day of the contract as determined by DHS through the end of the rate year.
(2)
Six-month report. Participating contracted providers
will provide DHS, in a method specified by DHS, a six-month Attendant Compensation
Report reflecting the activities of the provider while delivering contracted
services from the first day of the rate year through the last day of February
of the rate year. DHS will place on vendor hold contracted providers failing
to submit an acceptable six-month Attendant Compensation Report within 30
days of the last day of February of the rate year until DHS receives and processes
an acceptable report. The report must be submitted for each participating
contract if the provider requested participation individually for each contract;
or, if the provider requested participation as a group, the report must be
submitted as a single aggregate report covering all participating contracts
within one program of the provider. Participating providers will use this
six-month report to assist them in determining their level of compliance with
the spending requirements and to take any appropriate action necessary to
come into compliance with the spending requirements. The provider is responsible
for the management of attendant compensation expenditures in compliance with
the spending requirements stated in subsection (s) of this section.
(3)
Other reports. DHS may require other reports from
all contracts as needed.
(4)
Vendor hold. DHS will place on hold the vendor payments
for any contractor who does not submit an Attendant Compensation Report completed
in accordance with all applicable rules and instructions by the due dates
described in this subsection. This vendor hold will remain in effect until
an acceptable Attendant Compensation Report is received by DHS.
(i)
Attendant Compensation Report contents. Each Attendant
Compensation Report will include the following information:
(1)
attendant hours worked for attendants as defined in subsection
(b) of this section for the reporting period;
(2)
attendant compensation cost center costs for attendants
as defined in subsection (b) of this section for the reporting period;
(3)
total units of service accrued during the reporting
period; and
(4)
other information determined necessary by DHS.
(j)
Completion of compensation reports. All Attendant Compensation
Reports must be completed in accordance with the provisions of §§20.102
- 20.105 of this title (relating to General Principles of Allowable and Unallowable
Costs, Specifications for Allowable and Unallowable Costs, Revenues, and General
Reporting and Documentation Requirements, Methods, and Procedures) and may
be reviewed or audited in accordance with §20.106 of this title (relating
to Basic Objectives and Criteria for Audit and Desk Review of Cost Reports).
(k)
Enrollment. Providers choosing to participate in the attendant
compensation rate enhancement must submit to DHS a signed enrollment contract
amendment as described in subsection (f) of this section. Participation is
determined separately for each program specified in subsection (a) of this
section. Participation will remain in effect, subject to availability of funds,
until the provider notifies DHS, in accordance with subsection (x) of this
section, that it no longer wishes to participate or until DHS excludes the
contract from participation for reasons outlined in subsection (u) of this
section. Contracts voluntarily withdrawing from participation will have their
participation end effective with the date of withdrawal as determined by DHS.
Contracts excluded from participation will have their participation end effective
on the date determined by DHS.
(l)
Determination of attendant compensation rate component
for participating contracts. For each of the programs identified in subsection
(a) of this section DHS will calculate an attendant compensation rate component
for participating contracts from subsection (k) of this section and for the
first 60 days of a new contract from subsection (g) of this section as follows.
(1)
Determine for each contract included in the cost report
data base used in the determination of rates in effect on September 1, 1999,
the attendant compensation cost center from subsection (c) of this section.
(2)
Adjust the cost center data from paragraph (1) of
this subsection, as specified in §20.108 of this title (relating to Determination
of Inflation Indices), to inflate the costs to the prospective rate year.
(3)
For each contract included in the cost report data
base used in the determination of rates in effect on September 1, 1999, divide
the result from paragraph (2) of this subsection by the units of service and
multiply the result by 1.044 for all programs in subsection (a) of this section
except for RC and AL/RC which are multiplied by 1.07. The result is the attendant
compensation rate component for participating contracts and the first 60 days
of new contracts.
(4)
The cost base from paragraph (1) of this subsection
used in determining the attendant compensation rate component will not change
over time, except for adjustments for inflation from paragraph (2) of this
subsection. DHS may recommend adjustments to the rates in accordance with §20.109
of this title (relating to Adjusting Reimbursement When New Legislation, Regulations,
or Economic Factors Affect Costs).
(m)
Determination of attendant compensation rate component
for nonparticipating contracts. For each of the programs identified in subsection
(a) of this section DHS will calculate an attendant compensation rate component
for nonparticipating contracts as follows.
(1)
Determine for each contract included in the cost report
data base used in determination of rates in effect on September 1, 1999, the
attendant compensation cost center from subsection (c) of this section.
(2)
Adjust the cost center data from paragraph (1) of
this subsection in order to account for inflation utilizing the inflation
factors used in the determination of the September 1, 1999 rates.
(3)
For each contract included in the cost report data
base used in determination of rates in effect on September 1, 1999, divide
the result from paragraph (2) of this subsection by the units of service and
multiply the result by 1.044 for all programs in subsection (a) of this section
except for RC and AL/RC which is multiplied by 1.07. The result is the attendant
compensation rate component for nonparticipating contracts.
(4)
The attendant compensation rate component will remain
constant over time, except for adjustments necessitated by increases in the
minimum wage. In such cases, adjustments to the nonparticipating rates are
limited to ensuring that these rates are adequate to cover mandated minimum
wage levels.
(n)
Determination of attendant compensation rate enhancements.
DHS will determine attendant compensation rate enhancement increments associated
with each enhanced attendant compensation level. The attendant compensation
rate enhancement increments will be determined by using data from sources
such as cost reports, surveys, and/or other relevant sources. The attendant
compensation rate enhancement increments will be determined by taking into
consideration quality of care, labor market conditions, economic factors,
and budget constraints. The attendant compensation rate enhancement increments
will be determined on a per-unit-of-service basis applicable to each program
or service.
(o)
Enhanced attendant compensation. Participating contracts
desiring to provide attendant compensation above the level included in subsection
(l) of this section may request attendant compensation increments from an
array of enhanced attendant compensation options and associated add-on payments
determined in subsection (n) of this section during open enrollment.
(p)
Granting additional attendant compensation rate enhancement
increments. DHS divides all requests for attendant compensation rate enhancement
increments into two groups: pre-existing rate enhancement increments which
providers requested to carry over from the prior year and newly requested
rate enhancement increments. Newly requested rate enhancement increments may
be requested from providers that were nonparticipants in the prior year or
by providers which were participants during the prior year desiring to be
granted additional rate enhancement increments. Using the process described
herein, DHS first determines the distribution of carry-over rate enhancement
increments. If funds are available after the distribution of carry-over rate
enhancement increments, DHS determines the distribution of newly requested
rate enhancement increments as follows:
(1)
DHS determines projected units of service for contracts
requesting each enhancement increment and multiplies this number by the enhancement
rate add-on amount associated with that enhancement increment as determined
in subsection (n) of this section.
(2)
DHS compares the sum of the products from paragraph
(1) of this subsection to available funds.
(A)
If the product is less than or equal to available funds,
all requested enhancements are granted.
(B)
If the product is greater than available funds, enhancements
are granted in a proportional manner. Based upon an examination of existing
compensation levels and compensation needs, DHS may grant certain enhancement
options priority for proportional distribution.
(q)
Notification of granting of enhancements. Participating
contracts are notified, in a manner determined by DHS, as to the disposition
of their request for additional attendant compensation rate enhancement increments.
(r)
Total attendant compensation rate for participating contracts.
Each participating contract will receive an attendant compensation rate equal
to the attendant compensation rate component for participating contracts from
subsection (l) of this section, plus any additional attendant compensation
rate enhancement payments granted to the contract.
(s)
Spending requirements for participating contracts. DHS
will determine from the Attendant Compensation Report, as specified in subsection
(h) of this section, the amount of attendant compensation spending per unit
of service delivered. The providers' compliance with the spending requirement
is determined based on the total attendant compensation spending as reported
on the Attendant Compensation Report for each participating contract if the
provider requested participation individually for each contract. If the provider
specified that he wished to have all participating contracts be considered
as a group for purposes related to the attendant compensation rate enhancement,
as specified in subsection (f) of this section, compliance with the spending
requirement is based on the total attendant compensation as reported on the
single aggregate attendant compensation report described in subsection (h)
of this section. Compliance with the spending requirement is determined separately
for each program specified in subsection (a) of this section. DHS will calculate
recoupment, if any, as follows.
(1)
The attendant compensation spending per unit of service
will be multiplied by 1.07 to determine the adjusted attendant compensation
per unit of service.
(2)
The adjusted attendant compensation per unit of service
from paragraph (1) of this subsection will be subtracted from the accrued
attendant compensation revenue to determine the amount to be recouped by DHS.
If the adjusted attendant compensation per unit of service is greater than
or equal to the accrued attendant compensation revenue per unit of service,
there is no recoupment.
(3)
The amount paid for attendant compensation per unit
of service after adjustments for recoupment must not be less than the amount
determined in subsection (m) of this section.
(t)
Notification of recoupment. Providers will be notified
in a manner specified by DHS within 90 days of the due date of their annual
Attendant Compensation Report as described in subsection (h)(1) of this section
or within 90 days of the date the report is submitted, whichever is later,
of the amount to be repaid to DHS. If a subsequent review or audit results
in audit adjustments to the annual Attendant Compensation Report that changes
the amount to be repaid to DHS, the provider will be notified in writing of
the adjustments and the adjusted amount to be repaid to DHS. DHS will recoup
any amount owed from a provider's vendor payment(s) following the date of
the notification letter.
(u)
Exclusion from participation. If the attendant compensation
report described in subsection (h)(1) of this section indicates that the participating
provider did not spend 90% of the accrued total attendant compensation rate
described in subsection (r) of this section on attendant compensation spending
as determined from subsection (s) of this section, DHS will notify the provider
of the noncompliance. If the subsequent six-month compensation report from
subsection (h)(2) of this section indicates that the provider has not spent
90% of the attendant compensation revenue on attendant compensation spending,
the contract will be excluded from participation in the attendant rate enhancement
effective immediately upon notice of failure to meet the spending requirement.
The contract will be excluded from participation in the attendant compensation
rate enhancement and will remain a nonparticipant for the remainder of the
rate year plus an additional rate year.
(v)
Contract terminations.
(1)
For terminating participants who are not part of a group
of participating contracts as defined in subsection (f) of this section, DHS
will place a vendor hold on the payments of the contracted provider until
DHS receives an acceptable Attendant Compensation Report, as specified in
subsection (h)(1)(A) of this section, and funds identified for recoupment
from subsection (s) of this section are repaid to DHS. DHS will recoup any
amount owed from the provider's vendor payments that are being held. In cases
where funds identified for recoupment cannot be repaid by the terminating
provider's last vendor payment, the responsible entity from subsection (cc)
of this section will be jointly and severally liable for any additional payment
due to DHS. Failure to repay the amount due or submit an acceptable payment
plan within 60 days of notification will result in placement of a vendor hold
on all DHS contracts controlled by the responsible entity and will bar the
responsible entity from enacting new contracts with DHS until repayment is
made in full.
(2)
For terminating participants that are a part of a
group of participating contracts in a program, the Attendant Compensation
Report required in subsection (h)(1)(A) of this section will be used, as specified
in subsection (s) of this section, to determine compliance with the spending
requirements.
(w)
Contract assignments. The following applies to contract
assignments.
(1)
Participation in the attendant compensation rate enhancement
confers to the provider or legal entity accepting the contract assignment.
(2)
When the contract assignment is a change only in
the organizational structure or name of the legal entity, the provider or
legal entity accepting the contract assignment is responsible for the reporting
requirements in subsection (h) of this section and for any recoupment amount
owed to DHS for the entire rate year identified, even if part of the rate
year was under the responsibility of the previous legal entity.
(3)
When the contract assignment is an ownership change
from one legal entity to a different legal entity and the prior legal entity
has no other remaining active participating contracts in a program:
(A)
DHS will place a vendor hold on the payments of the existing
contracted provider until DHS receives an acceptable Attendant Compensation
Report specified in subsection (h)(1)(B) of this section and until funds identified
for recoupment from subsection (s) of this section are repaid to DHS. DHS
will recoup any amount owed from the provider's vendor payments that are being
held.
(B)
In cases where funds identified for recoupment cannot
be repaid by the existing contracted provider's vendor payments that are being
held, the responsible entity from subsection (cc) of this section will be
jointly and severally liable for any additional payment due to DHS. Failure
to repay the amount due or submit an acceptable payment plan within 60 days
of notification will result in placement of a vendor hold on all DHS contracts
controlled by the responsible entity and will bar the responsible entity from
enacting new contracts with DHS until repayment is made in full.
(4)
When the contract assignment is an ownership
change from one legal entity to a different legal entity and the contract
is a part of a group of participating contracts in a program, DHS will use
the Attendant Compensation Report, which is required in subsection (h)(1)(B)
of this section, as specified in subsection (s) of this section to determine
compliance with the spending requirement.
(x)
Voluntary withdrawal. Participating contracts wishing
to withdraw from the attendant compensation rate enhancement must notify DHS
in writing by certified mail. Contracts voluntarily withdrawing must remain
nonparticipants for the remainder of the rate year and are excluded from participation
the following rate ear.
(y)
Adjusting attendant compensation requirements. Providers
that determine that they will not be able to meet their attendant compensation
requirements may request a reduction to their attendant compensation requirements
and associated enhancement payment. These requests will be effective the first
of the month following 30 days from the receipt of the request.
(z)
All other rate components. All other rate components will
continue to be calculated as specified in the program-specific reimbursement
methodology and will be uniform for all providers.
(aa)
Failure to document spending. Undocumented attendant
compensation expenses will be disallowed and will not be used in the determination
of the attendant compensation spending per unit of service in subsection (s)
of this section.
(bb)
Appeals. Subject matter of informal reviews and formal
appeals is limited as per §20.110 of this title (relating to Informal
Reviews and Formal Appeals).
(cc)
Responsible entities. The contracted provider, owner,
or legal entity which received the attendant compensation rate enhancement
is responsible for the repayment of the recoupment amount.
This agency hereby certifies that the proposal has been reviewed
by legal counsel and found to be within the agency's legal authority to adopt.
Filed with the Office of
the Secretary of State, on March 17, 2000.
TRD-200002006
Paul Leche
General Counsel, Legal Services
Texas Department of Human Services
Earliest possible date of adoption: April 30, 2000
For further information, please call: (512) 438-3108
Subchapter G. SUPPORT DOCUMENTS
40 TAC §46.7002
The Texas Department of Human Services (DHS) proposes an
amendment to §46.7002, concerning reimbursement methodology for residential
care: 1997 and subsequent cost reports, in its Licensed Personal Care Facilities
Contracting with the Texas Department of Human Services to Provide Residential
Care Services chapter.
The purpose of the amendment is to implement DHS's appropriations rider
37 regarding community care programs passed by the 76th legislature. The proposal
establishes procedures for providers to obtain additional funds for increased
compensation to attendants in select community care programs (Community Based
Alternatives Waiver, Community Living Assistance and Support Services, Primary
Home Care, Day Activity and Health Services, Deaf-Blind Multiple Disabilities
Waiver, and Residential Care). Providers receiving the additional funds must
demonstrate compliance with spending the increased funds on attendant compensation.
If a participating provider's allowable attendant compensation times 1.07
is less than the revenue accrued the difference will be recouped by DHS. Providers
who choose not to participate will have their total direct care staff rate
increase each year limited to adjustments necessitated by increases in the
minimum wage. The proposal modifies the cost areas of these programs to separate
the new attendant compensation cost area from other cost areas. Changes to
the Day Activity and Health Services, Primary Home Care, and Residential Care
programs are proposed to combine some of the cost areas.
The department is simultaneously proposing related policy in Chapters 20,
47, and 98, along with the Texas Health and Human Services Chapter 355, in
this issue of the
Texas Register
.
Eric M. Bost, commissioner, has determined that for the first five-year
period the proposed section will be in effect there will be fiscal implications
for state government as a result of enforcing or administering the section.
The effect on state government for the first five-year period the section
will be in effect is an estimated additional cost of $10,400,000 in fiscal
year (FY) 2001; $10,900,000 in FY 2002; $11,500,000 in FY 2003; $12,000,000
in FY 2004; and $12,600,000 in FY 2005. There will be no fiscal implications
for local government as a result of enforcing or administering the section.
Mr. Bost also has determined that for each year of the first five years
the section is in effect the public benefit anticipated as a result of enforcing
the section will be a mechanism for increasing compensation to attendants
in certain community care programs. There will be no adverse economic effect
on large, small, or micro businesses as a result of enforcing or administering
the section, because no changes in practice are required of any businesses.
The proposal will provide some additional funding for providers who choose
to increase the compensation paid to attendants in their programs. There is
no anticipated economic cost to persons who are required to comply with the
proposed section.
Questions about the content of this proposal may be directed to Carolyn
Pratt at (512) 438-4057 in DHS's Rate Analysis Division. Written comments
on the proposal may be submitted to Supervisor, Rules and Handbooks Unit-179,
Texas Department of Human Services E-205, P.O. Box 149030, Austin, Texas 78714-9030,
within 30 days of publication in the
Texas Register
.
The department will hold a public hearing on the proposal on Monday, April
17, 2000, at 1:30 in the John H. Winters Building Public Hearing Room, first
floor, East Tower, 701 West 51st Street, Austin.
The amendment is proposed under the Human Resources Code, Title
2, Chapters 22 and 32, which authorizes the department to administer public
and medical assistance programs; and under Texas Government Code §531.021,
which provides the Health and Human Services Commission with the authority
to administer federal medical assistance funds.
The amendment implements the Human Resources Code, §§22.001 -
22.030 and §§32.001 - 32.042.
§46.7002. Reimbursement Methodology for Residential Care[
(a)-(b)
(No change.)
(c)
Reimbursement determination.
(1)
(No change.)
(2)
Residential care reimbursement. DHS determines reimbursement
for residential care as follows.
(A)
DHS's cost determination process recasts reported allowable
expense data in a consistent manner to determine per diem costs. Reported
allowable expenses are combined into
four
[
(i)
attendant;
[
direct care;]
(ii)
other direct care;
[
food;]
[
meal preparation;]
[
activities;]
[
transportation;]
(iii)
[
(iv)
[
(B)-(D)
(No change.)
(E)
The attendant cost area from
subsection (c)(2)(A)(i) of this section will be calculated as specified in §20.112
of this title (relating to Attendant Compensation Rate Enhancement).
(F)
The following applies to the cost areas
from subsection (c)(2)(A)(ii)-(iv) of this section:
(i)
[
(ii)
[
(iii)
[
(3)
(No change.)
(d)-(g)
(No change.)
This agency hereby certifies that the proposal has been reviewed
by legal counsel and found to be within the agency's legal authority to adopt.
Filed with the Office of
the Secretary of State, on March 17, 2000.
TRD-200002007
Paul Leche
General Counsel, Legal Services
Texas Department of Human Services
Earliest possible date of adoption: April 30, 2000
For further information, please call: (512) 438-3108
Subchapter E. SUPPORT DOCUMENTS
40 TAC §47.5902
The Texas Department of Human Services (DHS) proposes an
amendment to §47.5902, concerning reimbursement methodology for Primary
Home Care and Family Care Services: 1997 and subsequent cost reports, in its
Primary Home Care chapter.
The purpose of the amendment is to implement DHS's appropriations rider
37 regarding community care programs passed by the 76th legislature. The proposal
establishes procedures for providers to obtain additional funds for increased
compensation to attendants in select community care programs (Community Based
Alternatives Waiver, Community Living Assistance and Support Services, Primary
Home Care, Day Activity and Health Services, Deaf-Blind Multiple Disabilities
Waiver, and Residential Care). Providers receiving the additional funds must
demonstrate compliance with spending the increased funds on attendant compensation.
If a participating provider's allowable attendant compensation times 1.07
is less than the revenue accrued the difference will be recouped by DHS. Providers
who choose not to participate will have their total direct care staff rate
increase each year limited to adjustments necessitated by increases in the
minimum wage. The proposal modifies the cost areas of these programs to separate
the new attendant compensation cost area from other cost areas. Changes to
the Day Activity and Health Services, Primary Home Care, and Residential Care
programs are proposed to combine some of the cost areas.
The department is simultaneously proposing related policy in Chapters 20,
46, and 98, along with the Texas Health and Human Services Chapter 355, in
this issue of the
Texas Register
.
Eric M. Bost, commissioner, has determined that for the first five-year
period the proposed section will be in effect there will be fiscal implications
for state government as a result of enforcing or administering the section.
The effect on state government for the first five-year period the section
will be in effect is an estimated additional cost of $10,400,000 in fiscal
year (FY) 2001; $10,900,000 in FY 2002; $11,500,000 in FY 2003; $12,000,000
in FY 2004; and $12,600,000 in FY 2005. There will be no fiscal implications
for local government as a result of enforcing or administering the section.
Mr. Bost also has determined that for each year of the first five years
the section is in effect the public benefit anticipated as a result of enforcing
the section will be a mechanism for increasing compensation to attendants
in certain community care programs. There will be no adverse economic effect
on large, small, or micro businesses as a result of enforcing or administering
the section, because no changes in practice are required of any businesses.
The proposal will provide some additional funding for providers who choose
to increase the compensation paid to attendants in their programs. There is
no anticipated economic cost to persons who are required to comply with the
proposed section.
Questions about the content of this proposal may be directed to Carolyn
Pratt at (512) 438-4057 in DHS's Rate Analysis Division. Written comments
on the proposal may be submitted to Supervisor, Rules and Handbooks Unit-179,
Texas Department of Human Services E-205, P.O. Box 149030, Austin, Texas 78714-9030,
within 30 days of publication in the
Texas Register
.
The department will hold a public hearing on the proposal on Monday, April
17, 2000, at 1:30 in the John H. Winters Building Public Hearing Room, first
floor, East Tower, 701 West 51st Street, Austin.
The amendment is proposed under the Human Resources Code, Title
2, Chapters 22 and 32, which authorizes the department to administer public
and medical assistance programs; and under Texas Government Code §531.021,
which provides the Health and Human Services Commission with the authority
to administer federal medical assistance funds.
The amendment implements the Human Resources Code, §§22.001 -
22.030 and §§32.001 - 32.042.
§47.5902. Reimbursement Methodology for Primary Home Care and Family Care Services[
(a)-(b)
(No change.)
(c)
Reimbursement determination. DHS determines reimbursement
in the following manner.
(1)
Cost determination by cost area. DHS combines reported
allowable costs for Primary Home Care and Family Care into
four
[
(A)
Field supervisors cost area.
This includes field supervisor's salaries, wages, benefits, and mileage reimbursement
expenses.
[
Field supervisors cost area.
This includes field supervisors' salaries, wages, training, and travel expenses.
These costs are divided by total hours of service, including total nonpriority
and Priority 1 service hours, in order to calculate each provider's field
supervisor unit cost.]
(B)
Nonpriority attendants cost
area. This includes nonpriority attendants' salaries and wages, benefits,
and mileage reimbursement expenses. This cost area is calculated as specified
in §20.112 of this title (relating to Attendant Compensation Rate Enhancement).
[
Nonpriority attendants cost
area. This includes nonpriority attendants' salaries and wages, and travel
expenses. These costs are divided by total nonpriority hours of service in
order to calculate each provider's nonpriority attendant unit cost.]
(C)
Priority 1 attendants cost
area. This includes Priority 1 attendants' salaries and wages, benefits, mileage
reimbursement, expenses. This cost area is calculated as specified in §20.112
of this title (relating to Attendant Compensation Rate Enhancement).
[
Administration cost area.
This includes administrative salaries and wages, and other administrative
expenses. These costs are allocated between nonpriority and priority 1 services.
Administration expenses equal to $0.18 per Priority 1 hour of service are
allocated to Priority 1. To calculate the administration unit cost the remaining
non-allocated administration costs are divided by total nonpriority and Priority
1 hours of service. For nonpriority, the calculated administration unit cost
is the nonpriority administration unit cost. For Priority 1, the $0.18 is
added to the calculated administration unit cost to determine the Priority
1 administration unit cost.]
(D)
Building, administration and
other service cost area. This includes building, building equipment, and operation
and maintenance costs; administration costs; and other direct service costs.
Administration expenses equal to $0.18 per Priority 1 unit of service are
allocated to Priority 1. The administration costs remaining after this allocation
are summed with the facility and the other service costs.
[
Facility cost area. This
includes building and equipment expenses, and operation and maintenance expenses.
These costs are divided by total hours of service, including nonpriority services
and Priority 1 services in order to calculate each provider's facility unit
cost.]
[
Priority 1 attendants cost
area. This includes Priority 1 attendants' salaries and wages, and travel
expenses. These costs are divided by total Priority 1 hours of service in
order to calculate each provider's Priority 1 attendant unit cost.]
(2)
Recommended reimbursement
by cost area. For the cost areas described in paragraph (1)(A) and (D) of
this subsection, the following is calculated:
[
[
(A)
Projected costs. DHS projects
allowable expenses, excluding depreciation and mortgage interest, per unit
of service from each provider agency's reporting period to the next ensuing
reimbursement period. DHS determines reasonable and appropriate economic adjusters
as described in §20.108 of this title (relating to Determination of Inflation
Indicies) to calculate the projected expenses. DHS also adjusts reimbursement
where new legislation, regulations, or economic factors affect costs as specified
in §20.109 of this title (relating to Adjusting Reimbursement When New
Legislation, Regulations, or Economic Factors Affect Costs).
(B)
Projected cost per unit of
service. To determine the projected cost per unit of service for each provider
agency, the total projected allowable costs for each cost area are divided
by total units of service, including nonpriority services and Priority 1 services,
in order to calculate the projected cost per unit of service for each cost
area.
(C)
Projected cost arrays. DHS
rank orders from low to high all provider agencies' projected allowable costs
per unit of service and each provider agencies' corresponding units of service
for each cost area.
[
[
(D)
[
(3)
[
(A)
For nonpriority clients. DHS determines the recommended
reimbursement by summing the recommended reimbursement described in paragraph
(2)
[
(B)
For Priority 1 clients. DHS determines the recommended
reimbursement by summing the recommended reimbursement described in paragraph
(2)
[
(4)
[
(5)
[
(d)-(e)
(No change.)
This agency hereby certifies that the proposal has been reviewed
by legal counsel and found to be within the agency's legal authority to adopt.
Filed with the Office of
the Secretary of State, on March 17, 2000.
TRD-200002008
Paul Leche
General Counsel, Legal Services
Texas Department of Human Services
Earliest possible date of adoption: April 30, 2000
For further information, please call: (512) 438-3108
Subchapter I. REIMBURSEMENT METHODOLOGY FOR DAY ACTIVITY AND HEALTH SERVICES (DAHS)
40 TAC §98.6907
The Texas Department of Human Services (DHS) proposes an
amendment to §98.6907, concerning reimbursement methodology for residential
care: 1997 and subsequent cost reports, in its Adult Day Care and Day Activity
and Health Services Requirements chapter.
The purpose of the amendment is to implement DHS's appropriations rider
37 regarding community care programs passed by the 76th legislature. The proposal
establishes procedures for providers to obtain additional funds for increased
compensation to attendants in select community care programs (Community Based
Alternatives Waiver, Community Living Assistance and Support Services, Primary
Home Care, Day Activity and Health Services, Deaf-Blind Multiple Disabilities
Waiver, and Residential Care). Providers receiving the additional funds must
demonstrate compliance with spending the increased funds on attendant compensation.
If a participating provider's allowable attendant compensation times 1.07
is less than the revenue accrued the difference will be recouped by DHS. Providers
who choose not to participate will have their total direct care staff rate
increase each year limited to adjustments necessitated by increases in the
minimum wage. The proposal modifies the cost areas of these programs to separate
the new attendant compensation cost area from other cost areas. Changes to
the Day Activity and Health Services, Primary Home Care, and Residential Care
programs are proposed to combine some of the cost areas.
The department is simultaneously proposing related policy in Chapters 20,
46, and 47, along with the Texas Health and Human Services Chapter 355, in
this issue of the
Texas Register
.
Eric M. Bost, commissioner, has determined that for the first five-year
period the proposed section will be in effect there will be fiscal implications
for state government as a result of enforcing or administering the section.
The effect on state government for the first five-year period the section
will be in effect is an estimated additional cost of $10,400,000 in fiscal
year (FY) 2001; $10,900,000 in FY 2002; $11,500,000 in FY 2003; $12,000,000
in FY 2004; and $12,600,000 in FY 2005. There will be no fiscal implications
for local government as a result of enforcing or administering the section.
Mr. Bost also has determined that for each year of the first five years
the section is in effect the public benefit anticipated as a result of enforcing
the section will be a mechanism for increasing compensation to attendants
in certain community care programs. There will be no adverse economic effect
on large, small, or micro businesses as a result of enforcing or administering
the section, because no changes in practice are required of any businesses.
The proposal will provide some additional funding for providers who choose
to increase the compensation paid to attendants in their programs. There is
no anticipated economic cost to persons who are required to comply with the
proposed section.
Questions about the content of this proposal may be directed to Carolyn
Pratt at (512) 438-4057 in DHS's Rate Analysis Division. Written comments
on the proposal may be submitted to Supervisor, Rules and Handbooks Unit-179,
Texas Department of Human Services E-205, P.O. Box 149030, Austin, Texas 78714-9030,
within 30 days of publication in the
Texas Register
.
The department will hold a public hearing on the proposal on Monday, April
17, 2000, at 1:30 in the John H. Winters Building Public Hearing Room, first
floor, East Tower, 701 West 51st Street, Austin.
The amendment is proposed under the Human Resources Code, Title
2, Chapters 22 and 32, which authorizes the department to administer public
and medical assistance programs; and under Texas Government Code §531.021,
which provides the Health and Human Services Commission with the authority
to administer federal medical assistance funds.
The amendment implements the Human Resources Code, §§22.001 -
22.030 and §§32.001 - 32.042.
§98.6907. Reimbursement Methodology for Day Activity and Health Services[
(a)-(e)
(No change.)
(f)
Reimbursement determination. DHS determines reimbursement
in the following manner.
(1)-(3)
(No change.)
(4)
DHS staff combine allowable reported costs into the
following
four
[
(A)
Attendant cost area. This
cost area is calculated as specified in §20.112 of this title (relating
to Attendant Compensation Rate Enhancement).
[
Salaries and benefits cost
area includes the salaries, wages, payroll taxes, and benefits of Day Activity
and Health Services direct service personnel and drivers.]
(B)
Other direct care costs. This
cost area includes other direct care staff; food and food service costs; activity
costs; and other direct service costs.
[
Transportation cost area
includes the rental or lease of transportation equipment and operating costs.
The driver's salary is not included in this cost area.]
(C)
Facility cost area. This cost
area includes building, maintenance staff, and utility costs.
[
Food and food service cost
area includes the cost of meals, related supplies, dieticians, and food servers.]
(D)
Administration and transportation
cost area. This cost area includes transportation, administrative staff, and
other administrative costs.
[
Building, equipment, and
capital cost area includes all building operation expenses.]
[
Utility cost area includes
all water, electric, gas, and telephone expenses.]
[
Direct programmatic expenses
cost area includes the costs of medical and activity supplies, and administration,
including administrative staff.]
(5)
For the cost areas described in paragraph
(4)(B)-(D) of this subsection, allowable
[
(6)
(No change.)
(g)-(j)
(No change.)
This agency hereby certifies that the proposal has been reviewed
by legal counsel and found to be within the agency's legal authority to adopt.
Filed with the Office of
the Secretary of State, on March 17, 2000.
TRD-200002009
Paul Leche
General Counsel, Legal Services
Texas Department of Human Services
Earliest possible date of adoption: April 30, 2000
For further information, please call: (512) 438-3108
Chapter 809.
CHILD CARE AND DEVELOPMENT
The Texas Workforce Commission (Commission) proposes amendments to §§809.12,
809.46, and 809.124 relating to Child Care services.
Purpose: The purpose of the amendments is to remove references to the categorical
Child Care Plans that local workforce development boards (Boards) have previously
submitted to the Commission, because the Commission is designing an integrated
planning process to consolidate the separate plans relating to child care
and workforce training and services into one integrated plan for each local
workforce development area (workforce area). The Commission anticipates that
the benefits of a more integrated planning process will assist Boards in coordinating
and utilizing local funds in a more efficient manner.
Goals: Child Care services are provided to low-income families to create
and promote long-term self-sufficiency by enabling parents to work or attend
education or training activities. Such services offer affordable, accessible,
and quality child care that promotes the physical, social, emotional, and
intellectual development and safety of children. Recognizing that parents
best understand the needs of their children, these services empower parents
to make informed choices regarding child care that best suit the family's
needs. The Commission also advocates improvements in the availability, affordability,
and quality of child care while supporting health, safety, licensing, and
regulatory standards for child care providers. The goal is to coordinate workforce
services, to leverage private and public funds at the local level, and to
fully integrate child care for low-income families with the network of workforce
training and services under the administration of the Boards.
Integrated Plans: To assist the Boards in more fully incorporating and
coordinating child care services into a comprehensive one-stop network of
services provided to help low-income families as they move toward self-sufficiency
by providing child care subsidies to parents to support work, training, or
education, the Commission is developing an integrated planning process for
Boards that would remove the need for a separate child care plan and replace
that separate plan with an integrated workforce training and services plan.
Background: The purpose of the child care rules is to fully integrate child
care services for low-income families with the network of workforce training
and services under the administration of the Boards. Child care services are
subsidized for families seeking to become independent from or who are at risk
of becoming dependent on public assistance, while parents are either working
or in educational or training activities.
In January 1999, the Commission adopted changes to the former child care
rules for implementation by the Boards by September 1, 1999, which allowed
the Boards more flexibility in tailoring the design and management of the
delivery of child care services to best meet the needs of the residents and
employers in the workforce areas. In preparation for implementing the changes
set forth in the rules applicable on September 1, 1999, the Boards submitted
specific child care plans to the Commission by July 1, 1999. In the child
care plans the Boards assessed the need for child care in their individual
local workforce development areas, tailored a unique plan for child care service
delivery, and described a method for overseeing the delivery of this vital
service to ensure families' steady transition to self-sufficiency.
The revisions to the rules in January 1999 incorporated changes necessitated
by federal regulations set forth in 45 CFR Parts 98 and 99. The rules provided
flexibility for the Boards to fulfill their responsibilities in meeting the
needs of parents and children residing in the workforce areas. Prior to the
revisions of the rules, the Commission previously set prescribed methods for
compliance with federal and state statutes. The changes to the rules enhanced
the ability of the Boards to develop policies and procedures for administering
child care services that best fit the local needs. For example, the level
of state median income for eligibility was changed to match the criteria contained
in the federal regulations at 45 CFR Parts 98 and 99, which is an income limit
that does not exceed 85% of the state median income for a family of the same
size. Boards were able to establish local policies that set an eligible income
level as equal to or lower than the 85% level. The Commission encouraged the
Boards to set local policies that would use the funds in the most effective
manner to assist people who are transitioning off of public assistance or
who are at risk of becoming dependent on public assistance.
The enhanced flexibility afforded to the Boards ensures that Board policies
maximize the use of funds by tailoring the design and management of the delivery
of child care services to meet the specific needs of each workforce area.
To assist the Boards in adapting to the increased flexibility provided under
state law and rules, the Commission offers continued training and technical
assistance to the Board members and staff regarding child care services.
Continuing Board Responsibilities: The Boards will continue to develop
and maintain policies and procedures for the design and management of the
delivery of child care services that address matters including, but not limited
to: parent co-payments, attendance policies, eligibility procedures, service
priorities, provider reimbursement rates, and other methods to utilize the
funds in a manner that addresses the needs of the workforce area efficiently
and effectively. Some methods of developing these policies have included Boards
examining the past practices of the Commission, examining recommended best
practices, or independently tailoring policies to meet local needs.
Coordinating Planning and Policies. In developing and modifying an integrated
plan and local policies for the design and management of the delivery of child
care services, the Boards shall seek input from the local entities as indicated
in 45 CFR Parts 98 and 99, and particularly §98.14, to coordinate with
state, federal, and local child care and early childhood development programs,
entities responsible for public health and public education, representatives
of local government, and members of the public, such as parents, employers,
and providers.
In addition, the Boards are required to design and manage the delivery
of child care services subject to the provisions of Texas Government Code,
Chapter 2308, as implemented by the Commission through 40 TAC Chapter 801
relating to Local Workforce Development Boards. Boards will continue to ensure
access to child care services in their networks of one-stop centers. The Boards
may continue to choose to integrate intake and eligibility with the services
handled by career center operators or to obtain other contractors. Telephone
access at the career centers to intake and eligibility contractors will continue
to meet the requirements of Texas Government Code, Chapter 2308.251
The Commission continues to provide the Boards with maximum flexibility,
in accordance with state and federal law and regulations, to design and manage
a service mechanism that will assist the greatest number of families in accessing
the most affordable, quality child care in each workforce area. In their role
as policymakers, the Boards are subject to all the requirements of the Texas
Open Meetings Act, thus ensuring that parents, providers, contractors and
potential contractors, employers, and the public in general will have the
opportunity to participate and comment on proposed child care administrative
policies.
Boards will also continue to be required to follow the procedures for
making changes to each Board's integrated workforce training and services
plan, including the strategic and operational portions consistent with Texas
Government Code, Chapter 2308 and 40 TAC Chapter 801 relating to Local Workforce
Development Boards.
Randy Townsend, Director of Finance, has determined that for each year
of the first five years the amendments will be in effect, the following statements
will apply:
There are no additional estimated costs to the state and to local governments
expected as a result of enforcing or administering the amendments;
There are no estimated reductions in costs to the state and to local governments
as a result of enforcing or administering the amendments;
There are no estimated losses or increases in revenue to the state or to
local governments as a result of enforcing or administering the amendments;
There are no foreseeable implications relating to costs or revenue of the
state or local governments as a result of enforcing or administering the amendments;
and
There are no anticipated economic costs to persons required to comply with
the amendments.
Mr. Townsend has also determined that there is no anticipated adverse impact
on small businesses as a result of enforcing or administering the rules because
small businesses are not regulated by or required to do anything by the amendments.
Mark Hughes, Director of Labor Market Information, has determined that
there is no significant negative impact upon employment conditions in this
state as a result of the proposed amendments.
Jean Mitchell, Director of Workforce and Development, has determined that
for each year of the first five years the amendments are in effect, the public
benefit anticipated as a result of enforcing the amendments will be to help
ensure a more effective use of child care funds to assist Boards in supporting
employment, training, and education.
Comments on the proposal may be submitted to Gary Frederick, Texas Workforce
Commission Building, 101 East 15th Street, Room 440T, Austin, Texas 78778,
(512) 305-9672. Comments may also be submitted via fax to (512) 463-7379 or
e-mailed to: Gary.Frederick@twc.state.tx.us. Comments must be received by
the Commission within thirty days from the date of the publication in the
Subchapter B. GENERAL MANAGEMENT REQUIREMENTS
40 TAC §809.12
The amendments to the rules are proposed under Texas Labor
Code §§301.061 and 302.002, which provide the Texas Workforce Commission
with the authority to adopt, amend, or repeal such rules as it deems necessary
for the effective administration of the Commission's responsibilities.
The amendments to the rules affect Texas Labor Code, Chapter 302, and Texas
Human Resources Code, Chapters 31 and 44.
§809.12.Board Planning and Policies [
(a)
Planning. A Board shall, as part of its integrated
workforce training and services plan, develop, amend and modify the plan to
incorporate and coordinate the design and management of the delivery of child
care services with the delivery of other workforce employment, training and
education services identified in Texas Government Code §2308.251
(b)
Policies. A Board shall develop, adopt, and modify
its policies for the design and management of the delivery of child care services
in a public process consistent with the methods required for compliance with
the Texas Open Meetings Act, Texas Government Code, Chapter 551
et seq.
A Board shall maintain written copies of the policies
and make such policies available to the Commission and the public upon request.
A Board shall also submit any modifications, amendments, or new policies to
the Commission no later than two weeks after adoption of the policy by the
Board.
[
(c)
Coordinating Planning and Policies. A Board shall
coordinate with federal, state and local child care and early development
programs and representatives of local governments in developing its integrated
plan and its policies for the design and management of the delivery of child
care services, and shall maintain written documentation of that coordination.
[
This agency hereby certifies that the proposal has been reviewed
by legal counsel and found to be within the agency's legal authority to adopt.
Filed with the Office of
the Secretary of State, on March 17, 2000.
TRD-200002018
J. Ferris Duhon
Assistant General Counsel
Texas Workforce Commission
Earliest possible date of adoption: April 30, 2000
For further information, please call: (512) 463-8812
Chapter 46.
LICENSED PERSONAL CARE FACILITIES CONTRACTING WITH THE TEXAS DEPARTMENT OF HUMAN SERVICES TO PROVIDE RESIDENTIAL CARE SERVICES : 1997 and Subsequent Cost Reports ].
seven
] cost
areas:
(i)
(ii)
(iii)
(iv)
(v)
(vi)
] facility; and
(vii)
] administration
and
transportation
.
(E)
] Each provider's total reported
allowable costs, excluding depreciation and mortgage interest, are projected
from the historical cost-reporting period to the prospective reimbursement
period as described in §20.108 of this title (relating to Determination
of Inflation Indices). The prospective reimbursement period is the period
of time that the reimbursement is expected to be in effect.
(F)
] Cost area per diem expenses
are calculated by dividing total reported allowable costs for each cost area
by the total days of service. DHS rank orders cost area per diem expenses
from low to high to produce projected per diem expense arrays.
(G)
] DHS determines reimbursement
by selecting from each cost area the median day of service and the corresponding
per diem expense times 1.07. The resulting cost area amounts are totaled to
determine the per diem reimbursement.
Chapter 47.
PRIMARY HOME CARE : 1997 and Subsequent Cost Reports ].
five
] cost areas, after allocating payroll taxes to each salary
line item on the cost report on a pro rata basis based on the portion of that
salary line item to the amount of total salary expense and after applying
employee benefits directly to the corresponding salary line item.
(A)
(B)
(C)
(D)
(E)
(2)
]
Projected costs. DHS projects
allowable expenses, excluding depreciation and mortgage interest, per hour
of service from each provider agency's reporting period to the next ensuing
reimbursement period. DHS determines reasonable and appropriate economic adjusters
as described in §20.108 of this title (relating to Determination of Inflation
Indices) to calculate the projected expenses. For providers reporting traditional
workers' compensation insurance (WCI) policy premium costs, their reported
workers' compensation costs are inflated by applying the WCI index as calculated
in §20.108(c)(2) of this title (relating to Determination of Inflation
Indices), plus additional inflation percentages for a risk pool surcharge
and for premium differential and modifiers associated with the home health
industry. DHS also adjusts reimbursement where new legislation, regulations,
or economic factors affect costs as specified in §20.109 of this title
(relating to Adjusting Reimbursement When New Legislation, Regulations, or
Economic Factors Affect Costs). Depreciation and mortgage interest expenses
are not projected.
]
(3)
]
Projected cost arrays. To
calculate the reimbursement per hour of service, DHS rank orders from low
to high all provider agencies' projected allowable costs per hour of service
in each cost area and all provider agencies' projected total costs.
]
(4)
] Recommended reimbursement
for each cost area component. The hours of service used to calculate each
cost area component for each provider agency are summed until the median hour
of service is reached. The corresponding projected expense is the weighted
median cost component. The cost component for each cost area is multiplied
by 1.044 to calculate the recommended reimbursement for each cost area component.
(5)
] Total recommended
reimbursement.
(4)
] of this subsection
and the cost area component
from paragraph (1)(B) of this subsection
[
for the cost area components
described in paragraph (1)(A)-(D) of this subsection
].
(4)
] of this subsection
and the cost area component
from paragraph (1)(C) of this subsection
[
for the cost area component
described in paragraph 1(A) and (C)-(E) of this subsection
].
(6)
] Reimbursement determination
authority. The reimbursement determination authority is specified in §20.101
of this title (relating to Introduction).
(7)
] Desk reviews and field
audits of cost reports. DHS performs desk reviews or field audits on all contracted
providers. The frequency and nature of the field audits are determined by
DHS to ensure the fiscal integrity of the program. Desk reviews and field
audits will be conducted in accordance with §20.106 of this title (relating
to Basic Objectives and Criteria for Audit and Desk Review of Cost Reports),
and providers will be notified of the results of a desk review or an audit
in accordance with §20.107 of this title (relating to Notification of
Exclusions and Adjustments). Providers may request an informal review and,
if necessary, an administrative hearing to dispute an action taken by DHS
under §20.110 of this title (relating to Informal Reviews and Formal
Appeals).
Chapter 98.
ADULT DAY CARE AND DAY ACTIVITY AND HEALTH SERVICES REQUIREMENTS : 1997 and Subsequent Cost Reports ].
six
] cost areas:
(A)
(B)
(C)
(D)
(E)
(F)
Allowable
] costs
are totaled by cost area and then divided by the total units of service for
the reporting period to determine the cost per unit of service. DHS staff
rank from low to high all provider agencies' projected costs per unit of service
in each cost area. The median projected unit of service cost from each cost
area is then determined. Those median projected unit of service costs from
each cost area are totaled. That resulting total is multiplied by 1.044 and
becomes the recommended reimbursement.
Part 20.
TEXAS WORKFORCE COMMISSION and Plans ] for Child Care Services.
A Board shall develop policies and prepare, as part of its workforce training
and services plan (plan) and budget, a plan for the delivery of child care
in accordance with Commission rules and guidelines. The child care delivery
plan shall include evidence of coordination with federal, state, and local
child care and early childhood development programs and representatives of
local governments.
]
A Board shall develop policies for child care consistent
with the procedures for board plan amendments contained in §801.3 of
this title (relating to Requirements for Submission of Local Workforce Training
and Services Plans, Modifications and Amendments) and state and federal statutes
and regulations.
]
A board shall submit additional requirements, which would require
amending the Board's plan, as amendments to the Board's plan.
]
Subchapter C. REQUIREMENTS TO PROVIDE CHILD CARE